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Overweight, Weight Loss and Human Health In terms of public health, only smoking is more dangerous than obesity. Here's an update on the latest assessment techniques and, weight-loss regimens, including the newest medical treatment. Approximately 100 million Americans or almost 3 out of every 5 adults are overweight or obese. [ 1 ] The National Institutes of Health (NIH) and other organizations estimate that the costs of obesity to society in this country may be in excess of $ 100 billion annually. [ 2, 3 ] Obesity, in fact, is second today only to tobacco use as a public health hazard; it contributes to more than 300 000 premature deaths annually and is associated with a 2 -fold increase in mortality. [ 4 ] Obesity has been dramatically increasing among all groups in the past three decades and is associated with an increased incidence of many chronic diseases. Overweight and obesity contribute to cardiovascular disease (CVD), type 2 diabetes mellitus (DMII), hypertension (HTN), stroke, dyslipidemia, osteoarthritis, and some cancers. While many normal-weight adolescents strive to be thinner, an increasing segment of the pediatric population is becoming heavier. National survey data indicate that approximately 22 percent of children and adolescents are overweight.
The prevalence of overweight in children, adolescents and adults has increased significantly over the last 20 to 25 years. Overweight is defined with reference to population data that is specific for height, age and gender. The National Institutes of Health (NIH) and the World Health Organization (WHO) have formed guidelines for the identification, evaluation, and treatment of obesity in adults. These guidelines are based on BMI and are separated into four categories, ranging from overweight to obesity class 3. Overweight is classified as a BMI of 25 - 29. 9 kg/[m. sup. 2 ], obesity class 1 is 30 - 34. 9 kg/[m.
sup. 2 ], obesity class 2 is 35 - 39. 9 kg/[m. sup. 2 ], and obesity class 3 is classified as [is greater than or equal to] 40 kg/[m. sup. 2 ]. Data from the Third National Health and Nutrition Examination Survey (NHANES III) is often used and focuses on single health outcomes and population subgroups.
A group of researchers recently chose to use the data to study the relationship between severity of obesity and overweight and the prevalence of co-morbid diseases. This study provides estimates of the prevalence of these health conditions and their relation to race, ethnicity, and age. The sample consisted of 16, 884 adults, aged 25 years or older, who were classified as overweight or obese by the NIH guidelines. The co-morbid diseases that were selected for evaluation in this population were HTN, DMII, hypercholesterolemia, coronary heart disease (CHD), and gallbladder disease.
Osteoarthritis was also included even though it is not classified as a co-morbid disease. Sixty-three percent of men and 55 % of women were classified as overweight or obese. Hypertension was the most common health condition among both men and women in this population with an increase in prevalence seen with increasing weight category. The prevalence of gallbladder disease, DMII, and osteoarthritis also significantly increased with increasing BMI in both men and women. Elevated cholesterol levels were very common among this population. However, no relationship was observed with increasing Bmi's.
The prevalence of having two or more of the above health conditions increased with weight category across all racial and ethnic groups. The results showed that many health problems are associated with increasing body mass index. As confirmed by prior research, an especially strong relationship was seen between DMII and HTN and increasing weight categories. CHD was not included in the analysis of multiple co-morbid ities because of the possibility for "double-counting" it with those CHD risk factors (HTN, DMII, hypercholesterolemia) included already. Therefore, it is important to realize that the disease burden of obesity is likely underestimated. If this is the case and if obesity and overweight individuals are not encouraged or provided with the resources to lose weight, the disease burden will become overwhelming to them as well as to our health care system.
The age-adjusted prevalence of overweight derived from the 4 major national health surveys of the American population, conducted from 1960 to 1995, shows that the most significant weight gain has occurred among the heaviest men and women in the population -- body mass index (BMI), 30 kg/[m. sup. 2 ] or higher. [ 1 ] These are the very individuals who will suffer the most severe consequences from unwanted body fat. Why these groups are gaining more weight at an apparently more rapid rate than the other segments of the population is not clear. The problem, of course, is not confined to adults. Overweight and obesity are on the increase in the young as well. In minority populations, up to 30 % to 40 % of children and adolescents are overweight. [ 5, 6 ] An NIH expert panel recently described obesity as "a complex multi factorial chronic disease that develops from an interaction of genotype and the environment. " [ 1 ] All types of overweight and obesity are not the same.
There are different types of fat and varying phenotypic patterns of fat deposition. The type of fat accumulated and the site where it is deposited have different health implications and require different approaches to management. Why and how obesity develops is not completely understood, but it clearly involves much more than simply eating too much or exercising too little. Although dietary intake and physical activity are important factors in unwanted weight gain, the issue is far more complicated.
The emphasis today in trying to understand the origins of obesity has shifted from psychiatry to biochemistry. It is believed that persons who are obese experience depression, frustration, insecurity, and other negative feelings because of the way society reacts to them, not because of any inherent psychological disorder. In other words, the emotional distress associated with obesity is the consequence of being overweight, not the cause of it. The first law of thermodynamics is inviolable: energy can neither be created nor destroyed, only transferred from one form to another. In terms of the human body, this means that the amount of energy stored (primarily as body fat) equals the difference between energy intake (as food) and energy expended (as physical activity beyond the minimal level needed for everyday existence, basal metabolic needs, and the like). In this country, unfortunately, people who are struggling to control their weight now face 3 deadly adversities.
The first is a genetic predisposition that favors the development of obesity. The second is a destructive diet, high in fat and calories and low in nourishment. An estimated 60 % to more than 90 % of Americans are undernourished, meaning that despite excessive caloric intake they do not meet their daily recommended dietary allowances (RDAs) in one category or another. The third adversity is a sedentary lifestyle. Only about 9 % of men and 3 % of women exercise vigorously on a regular basis as part of their leisure-time activities. [ 7 ] Ironically, losing weight is really not that hard. Americans spend about $ 70 billion a year on commercial weight-loss products.
They would not do that, year in and year out, unless they actually lost weight. The problem is, the weight that they lose is almost always "found" again. Several national studies, including an NIH consensus conference, reveal that 90 % to 98 % of persons who successfully lose weight regain all of that weight (and often more), usually within 2 or at most 5 years. No weight-loss intervention strategy has been shown to successfully sustain weight loss. To lose weight, a person must reduce energy intake or increase energy expenditure or, preferably do both.
The majority of patients who come to our specialized center for weight management tell, "My doctor said I need to eat less and exercise more. " While that would indeed shift the energy balance equation toward weight reduction, successful management of obesity as a complex medical disease must go beyond simplistic advice. One dietary modification that is almost always essential to successful weight loss is a reduction in fat intake. Dietary analyses performed on overweight persons reveal that most have a very high dietary fat intake, usually over 40 % of an already excessive total caloric intake. In most cases, they consume more than 100 g of dietary fat daily (sometimes twice that amount or even higher). Many patients will do extremely well simply by reducing their dietary fat intake by 10 % to 20 % of their total caloric intake (or about 20 to 30 g of total dietary fat daily).
In this country, however, that is not easy to do, and most patients have to work very hard to achieve that goal. As th prvalnc of overnight and obesity has increase in th United Stats, so hav read health car costs both direct and indirect. Direct health car costs rfr to prvntiv, diagnostic, and treatment services (for xml, physician visits, medications, and hospital and nursing hom car). Indirect costs ar th valu of wags lost by popl until to work because of illness or disability, as wll as th valu of futur awnings lost by premature date. The costs of obesity turn out to be rather high, thus elimination of them would be highly beneficial for the society as a whole. Word count: 1500 Bibliography: References: (1. ) Clinical Guidelines on the Identification, Evaluation, and Treatment of Overweight and Obesity in Adults.
The Evidence Report. National Institutes of Health. Bethesda, MD: National Heart, Lung, and Blood Institute. National Institute of Diabetes and Digestive and Kidney Diseases. NIH publication no. 98 - 4083, 1998. (2. ) Wolf AM, Colditz GA. Social and economic effects of body weight in the United States.
Am J Clin Nutr. 1996; 63 (3 Suppl). (3. ) Slidell JC. The impact of obesity on health status: some implications for health care coats. Int J Obes Relat Metab Disord. 1995; 19 (Suppl 6). (4. ) McGinnis JM Free WH. Actual causes of death in the United States. JAMA. 1993; 270 (18). (5. ) Najjar MF, Kuczmarski RJ. Anthropometric data and prevalence of overweight for Hispanics: 1982 - 84.
Vital Health Stat 11. 1989; (239): 1. (6. ) Done MA, Sempos CT, Grundy SM. Excess body weight. An under recognized contributor to high blood cholesterol levels in white American men. Arch Intern Med. 1993; 153 (9). (7. ) Thomas PR (ed). Weighing the Options: Criteria for Evaluating Weight-Management Programs.
Washington, DC, National Academy Press, 1995.
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Research essay sample on Overweight Weight Loss And Human Health
